National Women’s Health Policy 2010 National Women’s Health Policy 2010 National Women's Health Policy 2010 ISBN: 978-1-74241-363-1 Online ISBN: 978-1-74241-364-8 Publications Number: D0102 Copyright Statements: Paper-based publications © Commonwealth of Australia 2010 is work is copyright. Apart from any use as permied under the Copyright Act 1968, no part may be reproduced by any process without prior wrien permission from the Commonwealth. Requests and inquiries concerning reproduction and rights should be addressed to the Commonwealth Copyright Administration, Aorney-General's Department, Robert Garran Oces, National Circuit, Barton ACT 2600 or posted at hp://www.ag.gov.au/cca Internet sites © Commonwealth of Australia 2010 is work is copyright. You may download, display, print and reproduce this material in unaltered form only (retaining this notice) for your personal, non-commercial use or use within your organisation. 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Requests and inquiries concerning reproduction and rights should be addressed to Commonwealth Copyright Administration, Aorney-General's Department, Robert Garran Oces, National Circuit, Barton ACT 2600 or posted at hp://www.ag.gov.au/cca 3 Contents Ministerial Foreword 5 Executive Summary 7 Introduction 11 Policy Overview 12 Chapter One: History of the Policy and Policy Principles 15 Development of the First National Women’s Health Policy 15 Achievements of the First National Women’s Health Policy 15 Development of the National Women’s Health Policy 2010 16 e principles 17 Developing the goals 22 Identifying key health issues 22 Developing the key health ares identied in the consultations into priority health issues 25 e social determinants of health 26 Chapter Two: Key health challenges for Australian women today and into the future 27 Major health issues faced by Australian Women 27 Measures of general health 27 Burden of disease and injury 29 Health literacy 29 Women and ageing: changing demographics 30 Priority areas and targeted conditions 33 Discussion of the four key health issues 33 Chapter Three: Women’s experiences of health issues 43 Prevention of chronic disease through control of risk factors 43 Chronic diseases 43 Lifestyle risk factors 46 Mental health and wellbeing 52 Impact of violence on emotional and mental health 53 Mental health across the lifespan 53 Marginalised women 54 Use of mental health services 55 Sexual and reproductive health 56 Contraception and safe sex 56 Violence and sexual and reproductive health 57 Sexually transmied infections 58 Reproductive health 59 Maternal health 60 Ageing well 63 Arthritis and other musculoskeletal conditions 64 Dementia 65 Older women and violence 67 4 Chapter Four: Current and future government action against the four priority health issues 69 1. Prevention of chronic disease through the control of risk factors 69 Current government actions on the prevention of chronic diseases through the control of rick factors 69 Future government action on the prevention of chronic disease through the control of risk factors 75 2. Mental health and wellbeing 76 Current government action to improve mental health and wellbeing 76 Future government action to improve mental health and wellbeing 79 3. Sexual and reproductive health 79 Current government action to improve women’s sexual and reproductive health 79 Future government action to improve women’s sexual and reproductive health 83 4. Ageing well 83 Current government action to assist women to age well 83 Future government action to assist women to age well 84 Chapter Five: Social factors influencing women's health and wellbeing 85 Social determinants of health 86 Sex and gender 86 Life stages 87 Access to key resources 88 Diversity—ethnicity, geographic location, disability and sexuality 92 Government actions to address social determinants 95 Sex and gender 95 Access to resources 96 Diversity 99 National health reform 101 Access to health services 101 Health care reform agenda 102 Chapter Six: Goal areas 105 Goals 105 1. Highlight the signicance of gender as a key determinant of women’s health and wellbeing 106 2. Acknowledge that women’s health needs dier according to their life stage 108 3. Prioritise the needs of women with the highest risk of poor health 109 4. Ensure the health system is responsive to all women, with a clear focus on illness and disease prevention and health promotion 110 5. Support eective and collaborative research, data collection, monitoring, evaluation and knowledge transfer to advance the evidence base on women’s health 112 Appendix A: List of all Submissions Received 115 References 121 National Women’s Health Policy 2010 5 Foreword From the Minister for Health and Ageing Aer more than twenty years since the rst women’s health policy, the Gillard Government is pleased to be able to release the National Women’s Health Policy 2010. ere have been signicant changes in the way women live their lives since the release of the rst National Women’s Health Policy. e rst National Women’s Health Policy: Advancing Women’s Health in Australia released in 1989 was a response to some of the challenges for women of the time. e National Women’s Health Policy 2010 now provides a foundation to meet the challenges for women maintaining good health in the 21st Century. I know there is no ‘typical’ or ‘average’ Australian woman. Each of us has our own work demands, our own family circumstance and our own health needs. Never before have we seen such an enormous growth in chronic disease and considered how this will impact on our lives as we age. We also, unfortunately, still see large gaps in the health status for many Australian women, particularly those in low socioeconomic groups and for Aboriginal and Torres Strait Islanders. e aim of this new National Women’s Health Policy 2010 is to guide us through the next 20 years to improve the health and wellbeing of all women in Australia, especially those at greatest risk of poor health. is policy encourages the active participation of women managing their own health particularly through prevention and aims to promote health equity through our close aention to the social determinants of health including improvements in education and safe living conditions. e policy recognises that immediate, medium and long-term actions can be taken by individual women, policy makers, program managers and service providers, to improve women’s health. For a Gillard Labor Government, standing still in Health is not an option. I am proud of this Government’s broad ranging health reform agenda which provides a great opportunity for women to continue to feature in and contribute to the future of our health system. I wish to thank the many people that have provided input into the development of this new policy through public consultations and submission processes. With this input, the policy reects the broad and diverse range of issues that will impact on women’s health in the next twenty years. e National Women’s Health Policy 2010 provides us with a policy framework to guide future investments in women’s health and build the health and wellbeing of all Australian women. Nicola Roxon Minister for Health and Ageing National Women’s Health Policy 2010 6 National Women’s Health Policy 2010 7 Executive Summary Purpose e purpose of the National Women’s Health Policy 2010 is to continue to improve the health and wellbeing of all women in Australia, especially those at greatest risk of poor health. e policy recognises the solid foundation of the rst National Women’s Health Policy: Advancing Women’s Health in Australia which was released in 1989. It continues the commitment to building an environment where more can be done to ensure that all Australian women have beer health and health care. is policy encourages the active participation of women in their own health and aims to promote health equity through aention to the social determinants of health. e policy adopts a dual priority approach that recognises the importance of addressing immediate and future health challenges while also addressing the fundamental ways in which society is structured that impacts on women’s health and wellbeing. e policy reects the equal priorities of: • Maintaining and developing health services and prevention programs to treat and avoid disease through targeting health issues that will have the greatest impact over the next two decades; and • Aiming to address health inequities through broader reforms addressing the social determinants of health. Key health priorities and challenges Since the rst National Women’s Health Policy was released, women’s lives have undergone signicant social, economic and technological changes. Overall, signicant improvements have been made in the health of Australian women, for example in rates of cardiovascular disease, cancer and a reduction in smoking rates. However, these improvements have not been experienced equally throughout the community. Certain groups of Australia women, particularly Aboriginal and Torres Strait Islander women, experience markedly worse health than the general population. A range of socially based determinants can impact on the ability of some groups of Australian women to access the resources needed to maintain good health. A key ongoing health challenge is to address these inequalities. Some health issues, for example, risk factors such as obesity and mental health particularly anxiety and depression have become increasing issues for women over the last two decades. e next few decades will continue to see fundamental changes to the structure of the Australian population as a result of historic paerns of fertility, migration and changes in life expectancy. Projections indicate that women will make up an increasing proportion of the old and very old segment of the Australian population over time. e ageing of the female population will have a signicant impact on the Australian health system. For example, the burden of disease associated with dementia in women is estimated to double in the next 20 years. The purpose of the National Women’s Health Policy 2010 is to continue to improve the health and wellbeing of all women in Australia, especially those at greatest risk of poor health. National Women’s Health Policy 2010 8 Priority health issues rough research and consultation, a series of evidence-based health priorities have been identied that represent the major challenges associated with death and burden of disease for women in the next 20 years. ese health priority areas are: 1. Prevention of chronic diseases through the control of risk factors; targeting chronic disease such as cardiovascular disease, diabetes and cancer, as well as risk factors such as obesity, nutrition, physical inactivity, alcohol and tobacco consumption. e policy also encourages a clearer understanding of the context of women’s lives, including the barriers that prevent women taking up healthier lifestyle behaviours. 2. Mental health and wellbeing; targeting anxiety, depression and suicide. 3. Sexual and reproductive health; targeting access to information and services relating to sexual health, reproductive health, safe sex practices, screening and maternal health. e importance of the health of mothers prior to conception, during pregnancy and in the post-natal period can have a profound and long term eect on their own health and that of their children. 4. Healthy ageing; targeting musculo-skeletal conditions, disability and dementia. e policy highlights that the social, economic and environmental conditions under which women live and age can aect their experience of old age. Action areas Actions are drawn from existing Government responses and new actions are proposed in the following areas; prevention of chronic disease through the control of risk factors, mental health and wellbeing, sexual and reproductive health and healthy ageing. Social determinants of health ere is a complex relationship between physical and social determinants of health. e policy therefore focuses on highlighting the social determinants having the greatest impact on women’s lives. e social determinants of health examined in the National Women’s Health Policy are: • Sex and gender - these are major determinants of health and wellbeing, and it is important that these are considered to improve women’s access to health services and information. • Life stages - Research has demonstrated that the health needs of women dier through stages of their lifecycle. e evidence of the past 20 years has conrmed the importance of taking a life course approach, preventing the accumulation of health risk factors and giving girls and women age-appropriate health care they require. • Access to resources - Women’s access to key resources such as income, education, employment, social connections and safety and security, including freedom from violence, aect their health outcomes and their access to health care. ese factors are in turn implicated in women’s risk behaviours, although in complex and varied ways. • Diversity - Marginalisation and discrimination against diverse women, aect their access to resources and, therefore, impact their health and wellbeing. There is a complex relationship between physical and social determinants of health. The policy therefore focuses on highlighting the social determinants having the greatest impact on women’s lives. National Women’s Health Policy 2010 9 Five policy goals e policy examines longer term strategies for addressing the social determinants of health through the establishment of ve policy goals. ese are intended to highlight ways that gender inequality and health inequities (between women and men, and between diering groups of women) can be addressed. e policy goals are to: 1. Highlight the signicance of gender as a key determinant of women’s health and wellbeing. 2. Acknowledge that women’s health needs dier according to their life stage. 3. Prioritise the needs of women with the highest risk of poor health. 4. Ensure the health system is responsive to all women, with a clear focus on illness prevention and health promotion. 5. Support eective and collaborative research, data collection, monitoring, evaluation and knowledge transfer to advance the evidence base on women’s health. ere is an opportunity to ensure that these goals are reected in the health reform process, to develop a health system that is more responsive to the needs of Australian women. There is an opportunity to ensure that these goals are reflected in the health reform process, to develop a health system that is more responsive to the needs of Australian women. National Women’s Health Policy 2010 [...]... illness prevention and health promotion 5 Support effective and collaborative research, data collection, monitoring, evaluation and knowledge transfer to advance the evidence base on women’s health 11 National Women’s Health Policy 2010 Policy overview During 2009 and 2010, the Department of Health and Ageing coordinated the development of the National Women’s Health Policy 2010 The policy has its basis... against these four health priority issues are discussed in Chapter Four The National Women’s Health Policy key priority areas are: • Prevention of chronic disease and the control of risk factors; • Mental health and wellbeing; • Sexual and reproductive health; and • Healthy ageing 25 National Women’s Health Policy 2010 The social determinants of health The social determinants of health identified through... process began with the release of the paper Developing a Women’s Health Policy for Australia: Setting the Scene by the Minister for Health and Ageing, the Hon Nicola Roxon MP On 12 March 2009, 15 women’s health organisations were invited to attend a National Women’s Health Policy Roundtable in Canberra The Development of a New National Women’s Health Policy: Consultation Discussion Paper was released at... contributed towards the development of the First National Women’s Health Policy Achievements of the First National Women’s Health Policy The 1989 policy aimed to improve the health and wellbeing of all women in Australia with a focus on those most at risk and on making the health care system more responsive to women’s needs The 1989 policy aimed to improve the health and wellbeing of all women in Australia... Input was collected from the National Women’s Health Policy Roundtable, written submissions and public consultations and distilled to show what women currently see as the most important issues in their health and wellbeing These issues have been used to inform the goals and action areas of the National Women’s Health Policy 2010 The policy also uses recent evidence on women’s health to support the strategies... action areas in response to women’s concerns about the structures that deliver health care and information These were: • improvements in health services for women; • provision of health information; • research and data collection; • women’s participation in decision making in health; and • training of health care providers 15 National Women’s Health Policy 2010 The 1989 policy has been used as the... service planning for women’s health services at all levels of government over the past two decades Under the National Women’s Health Program a number of women’s health centres were built or extended; new health information and education strategies were developed in a variety of community languages; and specialised training on women’s health issues was developed for health providers The 1989 policy also resulted.. .National Women’s Health Policy 2010 10 Introduction Australia has made significant gains in women’s health since the introduction of the first National Women’s Health Policy in 1989 Australian women enjoy a longer life expectancy than most women from other countries Universal access to health care and essential pharmaceuticals means that treatment... Development of the First National Women’s Health Policy In September 1985 more than 700 women attending the Adelaide conference Women’s Health in a Changing Society producing a joint resolution that a National Women’s Health Policy be developed ‘based on a clear recognition of the position of women in society and the way this affects their health status and their access to health services appropriate... as possible The National Women’s Health Policy 2010 recognises the solid foundation of the first policy It continues the commitment to building an environment where more can be done to ensure that all Australian women have better health and health care In line with international developments and the Government’s social inclusion agenda, this policy emphasises prevention, addressing health inequalities . to the policy. National Women’s Health Policy 2010 1 4 National Women’s Health Policy 2010 1 5 Development of the First National Women’s Health Policy In. National Women’s Health Policy 2010 National Women’s Health Policy 2010 National Women's Health Policy 2010 ISBN: 978-1-74241-363-1